b"2021 CARES Annual Report 9 9 Volpp collapsed because of cardiac arrest. The cardiac arrest was caused by a heart attack. En route, paramedics called the hospital with details. A team was waiting in the cardiac catheterization lab. Doctors found one of his arteries 99% blocked. They performed a minimally invasive procedure that involved inflating a balloon to open the narrowed pathway and inserting a stent to keep it open. With his body on the mend, the unknown was his brain. Hed gone without a pulse, thus starving his body of oxygen, for about 14 minutes. Permanent brain damage can begin within minutes. Once he regained consciousness, Volpp was confused, as is typical. Yet by Saturday night, he understood all that went wrong with his heartand he began absorbing all that went right to fix it. 911 was called right away. White, then a police officer, provided CPR continuously until paramedics took over. Paramedics arrived with an AED within 5 minutes of the 911 call.The ambulance left 12 minutes later and made it to the hospital in 6 minutes. From reaching the hospital until Volpps artery was open (whats known as door-to-balloon time) took 1 hour, 8 minutes. The target is less than 1 hour, 30 minutes.With each successful step, his odds improved. Still, survival rates for cardiac arrest outside of a hospital nationally are around 10%. Harris, the on-site cardiologist, told Volpp the key to his survival was immediately receiving high-quality CPR. How do you know I received high-quality CPR? Volpp asked. Because Im talking to you 25 hours after the event, Harris replied. At 7:40 a.m. on Sunday, Volpp tapped out the following text to White: Hey John, I dont know how to thank you. I think you saved my life. I think Im doing OK now thanks to you*** For a few weeks after his life was saved, Volpps chest and ribs were sore. But it was sort of a pleasant reminder of how people helped me survive, he said. So I didn't really mind. He traded Ironman training for cardiac rehabilitation. A stress test showed no problems stemming from the repaired artery or elsewhere in his heart. Hes been cleared to exercise daily. Hes even rejoined his triathlon training club. Im choosing to believe the narrative that all these things perfectly fell into place to save my life for a reason, he said. Theres a lot for me to yet do in this world. Such as helping fewer people die of heart disease. Volpp is one of two leaders of a five-year grant from the National Institutes of Health to study how behavioral economic approaches (think, nudges) can increase physical activity among patients at higher risk of heart disease. He is also leading a multi-project initiative at Penn Medicine on reducing heart attack risk by influencing patient and clinician behavior and has published more than 150 articles on related topics. Its always been one of my most important efforts, he said, but now Im doubling down on it. Dr. Volpp Calls for EMS Agencies to Participate in CARES After His Cardiac Arrest During the AHA Scientific Sessions closing event in November 2021, Dr. Kevin Volpp talked to AHA president, Dr. Donald M. Lloyd-Jones, about the six calls to action that he thinks need to be considered in order to improve out-of-hospital cardiac arrest outcomes. Among the calls to action is for EMS agencies to join the CARES registry. Dr. Volpp experienced his cardiac arrest in Cincinnati, one of the first cities to join CARES. He credits the citys participation in CARES among the reasons why he survived. We have the CARES registry which I think many EMS agencies have found to be a very important quality improvement tool, he said.But only about half the US population is cared for by an EMS agency that participates in CARES now. Participation is voluntary. And funding is not all that stable. So, whatever we could do to incent EMS agencies to be part of the CARES registry and to stabilize funding would really help quality improvement efforts going forward."